BASEBALL: LEAGUE CHAMPIONSHIP SERIES; Experts Are Cautious On Strawberry's Odds

Since Darryl Strawberry, the 36-year-old Yankees outfielder, had surgery to remove a cancer from his colon on Oct. 3, his doctors and the Yankees have painted an optimistic picture of his chances for a long-term cure.

However, several cancer experts not connected with Strawberry's case were more cautious in their optimism about his future, because the detection of cancerous cells in even 1 of the 36 lymph nodes removed from his abdomen during the operation meant the cancer had spread. The finding meant Strawberry's post-operative course would include chemotherapy; if none of the lymph nodes had shown evidence of cancerous cells, presumably Strawberry would not have needed chemotherapy. The finding also substantially reduced the odds of a five-year cure, from the approximately 90 percent that could have been expected if the cancer had not spread.

Strawberry, described as ''still weak'' yesterday by Dr. Stuart Hershon, the Yankees' team physician, remains at Columbia-Presbyterian Medical Center in Manhattan. Hershon, a specialist in bone and joint surgery, said Strawberry ''needs to get his strength. He'll go home when he's ready.'' Hershon said that an earlier news release from Columbia-Presbyterian should not have stated that Strawberry would leave the hospital yesterday.

In the same news release, the hospital said that ''doctors are optimistic that he will make a complete recovery and return to full activities including playing major league baseball next season.'' There was no statistical information about his future.

Cancer experts said the odds of longer-term survival appeared to be in Strawberry's favor. But they gave widely ranging figures -- from 75 percent to 35 percent -- for the prospects of Strawberry's being cured in five years. The figures were based on large studies of patients with colon cancer.

Dr. Stanley R. Hamilton, the head of pathology at the University of Texas M. D. Anderson Cancer Center in Houston, and Dr. Alfred Cohen, a colon cancer surgeon at Memorial Sloan-Kettering Cancer Center in Manhattan, said Strawberry had a 70 percent to 75 percent five-year survival rate with adjuvant chemotherapy and about a 60 percent rate without such therapy.

However, Dr. Harmon Eyre, the chief medical officer of the American Cancer Society in Atlanta, gave a five-year survival rate of 50 percent to 65 percent. Dr. Mark W. Arnold, a colon cancer surgeon at Ohio State University Hospital in Columbus, gave a figure of 35 percent to 50 percent.

Other cancer experts who asked not to be identified gave figures similar to those offered by Dr. Eyre and Dr. Arnold.

The wide variation reflects several factors. One is that the odds depend on specific factors involved in a particular case. Strawberry's doctors at Columbia-Presbyterian have not discussed his case publicly, and news releases from the medical center have given few medical details of the type that doctors generally rely on in making such prognoses.

Most important, predicting an individual's prognosis is an inexact science because it can be extremely difficult to apply information derived from studies involving large numbers of patients to one person.

''There are clearly people who are in the highest adverse group who survive and people who are in the highly favorable group who do not,'' Dr. Hamilton said. ''We all get fooled.''

Nevertheless, Dr. Eyre said that even the limited available information about Strawberry's case makes his ''a very serious tumor.''

Strawberry's doctors have said they expect him to play next season. However, at what point in the season that might happen remains to be determined, because Strawberry will be getting chemotherapy over the next six months, and it is possible that he will experience unwanted symptoms from the anti-cancer drugs.

In one sense, the finding of only 1 cancerous lymph node among the 36 was good news for Strawberry because it indicated that the spread was limited. However, finding spread even to one node has put Strawberry in a more serious category of the standard cancer staging systems than his wife, Charisse, said they expected before the operation.

At that time, Charisse Strawberry said that the doctors expected Darryl to be in one of the two most favorable categories -- A or B (or I or II in another, more commonly used system). Such staging can be made only after pathologists examine the cancer and other tissue removed in surgery.

A news release from Columbia-Presbyterian last Thursday citing the doctors' optimism did not refer to the staging for Strawberry's cancer. But by definition, the detection of just the one cancerous node put him in the third-worst category -- either C or III, depending on the system.

Doctors rely heavily on such staging systems to give prognoses. For example, Ronald Reagan's colon cancer was classified as a B when it was removed while he was President in 1985. The colon cancer is not known to have recurred.

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Strawberry's case has drawn exceptional attention because he is so young, and colon cancers are rare in people his age. Only 1,700, or 2.5 percent, of the 62,900 colon cancer cases expected to be diagnosed in men in this country this year will be among men 40 and under.

The outlook for individuals with colon cancer has improved as the death rate has declined over the last two decades, the American Cancer Society said. Nevertheless, the estimates are that more than 130,000 cases of colon and rectal cancer will be diagnosed in Americans this year, and that they will cause 47,700 deaths.

When dealing with publicity about serious illnesses of celebrities, doctors and hospitals are mindful that such patients and their families will read or hear news reports about their cases. And sports organizations like the Yankees often try to put a favorable spin on the news for morale reasons.

With respect to the sketchy news releases in Strawberry's case, Dr. Hamilton said: ''Very obviously, it is not a complete picture. They have filtered what they want'' to disclose.

One hospital news release said that there was no evidence of cancer in the margins of the 16-inch piece that was removed from Strawberry's colon. But that was to be expected, because if cancerous cells were present at the margins, the surgeons would have just removed a longer piece.

Cancer experts said it was more important to know about the margins of the cancer itself, whether the cancer had penetrated deep into the walls of the tubular bowel or through it into adjacent tissues. But that information was not disclosed.

Before the operation, Charisse Strawberry said Darryl might need ''a sprinkling'' of radiation. However, the news releases have said nothing about radiation.

The news releases said nothing about special tests that pathologists can perform on the cancerous tissue removed to determine special characteristics of its basic molecular makeup. Strawberry's prognosis could be slightly better depending on the findings of such tests, Dr. Hamilton said.

Dr. Arnold said that for Strawberry ''it was better to have cancerous cells in one node instead of five or six.'' Dr. Arnold said that while he understood that people wanted Strawberry to have a favorable prognosis, he suspected ''it is not as good as they said.''

The news releases said that Strawberry is expected to take adjuvant chemotherapy. It is aimed at destroying any cancer cells that doctors could not see in the operation. A few years ago, doctors began prescribing adjuvant therapy for patients with type C or III colon cancers because that group has shown substantial benefit, Dr. Hamilton and Dr. Cohen said.

A current standard course of adjuvant chemotherapy for colon cancer includes a six-month course of two drugs: 5-fluorouracil and leucovorin. Dr. Cohen of Memorial Sloan-Kettering Cancer Center said that the drugs could be taken either once a week or for four or five consecutive days once a month.

Many people tolerate adjuvant chemotherapy with fewer unwanted side-effects than standard chemotherapy. But some do not, and the symptoms usually include nausea, vomiting and diarrhea. Strength is usually regained quickly after the therapy is stopped, Dr. Cohen said.

Strawberry's chemotherapy could be expected to begin in November. If he begins chemotherapy next month and suffers symptoms from it, it is questionable whether he would play in spring training.

The Baltimore Orioles' Eric Davis, who grew up with Strawberry in Los Angeles, underwent surgery for colon cancer last year and came back to play three months later, while still undergoing weekly chemotherapy treatments.

If colon cancer recurs, it is generally within the first five years of diagnosis, and usually within the first three years.